A unique program dedicated to helping people with low vision and blindness resume active, satisfying, and more independent lives
The Richard E. Hoover Low Vision Rehabilitation Services staff members work directly with visually impaired individuals to determine which devices and techniques will help them meet their personal goals.
What is Low Vision?
Low Vision is a visual condition that cannot be corrected by conventional eyeglasses, contact lenses or surgery. Low vision includes people with reduced visual acuity, narrowed visual fields, and blind spots in their central field of vision. They may need things bolder, brighter, or bigger than normal, or they may require special techniques to reduce their glare sensitivity.
Dr. Sunness is one of the pioneers in understanding how patients adapt after they develop blind spots in their vision. At Hoover, she provides comprehensive evaluations and visual function testing, as well as low vision evaluation. Treatment by Susan Garber, our low vision occupational therapist is also available. Dr. Sunness sees patients with a wide variety of conditions, including macular disease, retinal disease, glaucoma, optic nerve disease, and corneal disease. She also is actively engaged in clinical research in low vision.
Dry age-related macular degeneration
Dr. Sunness is recognized as one of the world's foremost authorities on the advanced dry form of age-related macular degeneration (also called geographic atrophy). She conducted the largest natural history study of this condition to date, and her work has served as the basis for designing clinical trials for possible treatments for this condition. Hoover Services offers a comprehensive evaluation, retinal examination, and low vision treatment.
Stargardt Disease (macular degeneration in young people)
Dr. Sunness is one of few ophthalmologists in the United States specializing in Stargardt disease. She follows about 150 patients with this condition. She has a collaborative relationship with Dr. Rando Allikmets, who discovered the abnormal gene in Stargardt disease, to provide genetic testing to patients.
Dr. Sunness works with many patients with Retinitis Pigmentosa. Hoover provides clinical visual function and electrophysiological testing, along with a full retinal evaluation and low vision evaluation and treatment.
Other macular and retinal disease
Dr. Sunness treats many patients with wet macular degeneration, diabetic retinopathy, and other hereditary and acquired macular and retinal diseases.
Dr. Sunness completed the summer genetics course at the Jackson Laboratory in Bar Harbor, Maine, in 2000. She collaborates with a number of geneticists who are studying ocular diseases, and arranges for genetic testing for her patients. DNA analysis of her patients has provided insight into possible genetic factors predisposing to macular degeneration.
Dr. Sunness is an author of 55 peer-reviewed papers. She has written more than 20 chapters in books relating to retinal and macular disease and visual function.
Janet S. Sunness, MD
Medical Director, Hoover Low Vision
Janet S. Sunness, MD
Medical Director, Hoover Low Vision
Michelle Bianchi, OTR/L, CLVT
Low Vision Occupational Therapist
Michelle Bianchi, OTR/L, CLVT
Michelle Bianchi is an occupational therapist and certified low vision therapist specializing in vision rehabilitation at GBMC’s Richard E. Hoover’s Low Vision Rehabilitation Services since November, 2012. Ms. Bianchi has helped many patients with low vision maximize their safety and independence with their desired activities of daily living since 2005.
Michelle earned a Bachelor of Science degree in both Psychology and Occupational Therapy & Occupational Science from Towson University. In June 2010, she completed her Graduate Certificate in Low Vision Occupational Therapy at the University of Alabama at Birmingham. Mrs. Bianchi has completed occupational therapy internships at Maryland General Hospital’s Bryn Mawr Rehabilitation Traumatic Brain Injury Unit, Kennedy Krieger’s Inpatient Hospital, Greater Baltimore Medical Center’s Transitional Care Unit, and The Sheppard and Enoch Pratt Hospital’s Dual Diagnoses of Addiction and Affective Disorders Unit. She was the Maryland Occupational Therapy Association’s recipient of the 2001 Henrietta Price Scholar Award. In 2009, she won the first prize in the 35th Annual Maddack Awards at the 2009 AOTA Conference in their professional division for a low vision device.
Michelle has over 15 years of occupational therapy experience including working with patients recovering from traumatic brain injury and physical disabilities. Ms. Bianchi is a member of the American Occupational Therapy Association AOTA), Maryland Occupational Therapy Association (MOTA), and Academy for Certification of Vision Rehabilitation and Education Professionals (ACVREP). Ms. Bianchi has spoken at national conferences on low vision, occupational therapy conferences, as well as to senior communities to promote hope for coping with a change in vision.
Carol Applegate, MLA, COT
Research Coordinator & Ophthalmic Technician
Sr. Medical Secretary
- Low Vision Evaluation
- Low Vision Occupational Therapy Evaluation and Treatment
- Low Vision Occupational Therapy Treatment in the home when indicated
- The VIEW (Vision - Information - Education - Wellness) - Retail Store
- Retinal Evaluation
- Specialized visual function testing and clinical electrophysiology
- Visual Field Tests
- Electroretinography (ERG and multifocal ERG)
- Visual evoked response (VER, or VEP)
- Electrooculography (EOG)
- Dark adaptation testing (SST)
- Color vision testing (D15, FM100 Hue)
- Fundus photography
- Optical Coherence Tomography (OCT) and Angiography
Services OfferedLow Vision Evaluation and Treatment: The low vision evaluation includes a thorough history of visual difficulties, determining if vision can be improved by refraction, measuring visual acuity, contrast sensitivity, visual fields, and reading difficulty, an assessment for the presence of central blind spots in the vision, and an ophthalmological evaluation. Treatment is then provided, often together with low vision occupational therapy evaluation and treatment.
Low Vision Occupational Therapy Evaluation and Treatment: The occupational therapist, Michelle Bianchi OTR/L, CLVT, will focus on analyzing and evaluating difficult daily living tasks and providing practical solutions to visual, physical and aging challenges. The occupational therapy exam provides education and training in using low vision devices and techniques. The treatment is geared to helping patients achieve their goals by making optimal use of their functional vision.
Low Vision Occupational Therapy Treatment in the home when indicated: After the initial occupational therapy evaluation at GBMC it is sometimes deemed beneficial for the client to be seen within his/her own home to allow for proper carry-over of training, assessing safety, lighting and provide home modifications to make living at home a success.
The VIEW (Vision - Information - Education - Wellness) The VIEW is Hoover Service's retail store with newest non-optical aides, such as phones, calendars, low-powered magnifiers and much more. It also is a showcase for high technology devices, such as video magnifiers. This store is available to anyone needing to purchase aids.
Retinal Evaluation: Dr. Sunness is an expert in medical retinal disease, including macular degeneration, diabetic retinopathy, retinitis pigmentosa, Stargardt disease, and other hereditary retinal diseases. The retinal evaluation includes a detailed examination, and testing and imaging with modern technology.
Specialized visual function testing and clinical electrophysiology: Dr. Sunness has done pioneering work in defining the visual difficulties associated with many eye diseases. Testing is useful for understanding the cause of unexplained vision loss, to understand the diagnosis and progression of a variety of retinal and optic nerve diseases, and for assessing for damage that occurs as a side effect of certain medications.
Microperimetry allows for the measurement of retinal function and identification of abnormalities in diagnostic imaging of the retina in macular degeneration, diabetic retinopathy, hereditary retinal and macular disease and other retinal disorders. It helps us in coaching patients to use their remaining vision more effectively.
Visual Field Tests are done to measure your "side" vision, which is important in driving and navigation.
Electroretinography (ERG and multifocal ERG) measures the electricity produced by the retina in response to light flashes. It is important for diagnosing certain diseases like retinitis pigmentosa, for evaluating for neurodegenerative diseases in early childhood, and for identifying the cause of unexplained vision loss.
Visual evoked response (VER, or VEP) measures how well the signal generated by seeing a pattern gets to the back of the brain. It is a sensitive measure of optic nerve function.
Electrooculography (EOG) measures the electrical voltage generated when the eye is in a bright versus a dark environment. This is useful for diagnosing a retinal condition called Best disease.
Dark adaptation testing (SST) measures the smallest amount of light a person can see after being in the dark for 30 minutes or more.
Color vision testing (D15, FM100 Hue) measures how well a person can distinguish different colors, using special testing that is also useful in patients with low vision. Helps to diagnose various optic nerve and retinal diseases.
Fundus photography documents abnormalities in the retina or optic nerve for future comparison.
Optical Coherence Tomography (OCT) and Angiography is a noninvasive imaging procedure that provides cross sectional images of the retinal layers and the ability to track changes to macular thickness over time.
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The VIEW is Hoover Services retail store with the newest non-optical aids, such as phones, calendars, low-powered magnifiers and much more. This store is available to anyone needing to purchase aids. It is also is a showcase for high technology devices, such as video magnifiers. You can walk into the VIEW and purchase non-optical aids, Monday through Thursday(8:30 AM to 4:30 PM) and Friday(8:30 AM - 12:00 PM).
New Patient Information
What will you need to bring to your appointment:
- Completed new patient paperwork
- Insurance card (s)
- Photo ID
- Magnifiers and glasses you have at home
- If your insurance is an HMO or Managed Care plan, please obtain the necessary referral form or pre-authorization prior to your visit.
- If it is determined that you would benefit from new glasses and a prescription, a payment of $28.00 will be collected at the end of your visit. Regretfully, most medical insurances do not cover the refraction completed during the exam.
- Bring a snack.